An EMR Update, a High-Risk Pool, and a Maze
Maine’s high risk pool has only 14 people in it. HT to Yglesias
Dodd-Frank regulation maze. (neat graphic) (HT to David Henderson)
Tag: "EMR"
Jun 28, 2011 | 5 comments | by John Goodman
Doctors Are Refusing to Treat Obese Patients, and Other News
Florida doctors are refusing to treat obese patients.
Under-doctored? Rural Americans get more surgeries than city folks.
Report: Electronic medical records are vulnerable. But surely you already knew that.
AMA report: Standardizing EMRs would “stifle innovation.” But surely you already knew that as well.
May 19, 2011 | 5 comments | by John Goodman
Electronic Medical Records: Should the SEC Track the Brokerage Accounts of Hospital Clerks?
Study after study suggests that mandatory electronic medical records will raise health care costs without generating significant benefits. Despite this, ObamaCare requires that individual health information be posted to insecure databases in order to facilitate widespread access to extensive detail about every individual’s health. When the person involved is an important figure in a publicly traded company, public disclosure of previously private health information can move markets. Access to that information in advance of a public announcement can create tidy trading profits.
To see how much money even relatively unsophisticated insider trading schemes can create, consider the case of Cheng Yi Liang, an FDA chemist recently arrested for insider trading on FDA drug approval information. Mr. Liang had access to DARRTS, a confidential FDA database that manages, tracks, and reports on the progress of new drug applications. The FDA usually delays the public announcement of its decision for 24 hours after it informs a new drug applicant of its decision.
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Apr 12, 2011 | 6 comments | by Linda Gorman
Why Electronic Medical Records Aren’t Being Used
About 20 percent of U.S. hospitals and 30 percent of office-based primary-care doctors — about 46,000 practitioners — had adopted a basic electronic record in 2010, according to government statistics. So why is that?
Such systems are hard to use and difficult to maintain. They disrupt clinical practice. They don’t increase efficiency and often don’t pay for themselves. They disrupt the doctor-patient interaction. And they are very, very expensive.
I fear that the current incentives — simple monetary carrots and sticks — that the government is trying in order to increase the use of information technology in the practice of medicine won’t work. Just as we have a patchwork insurance system in the US, we have a patchwork IT system as well. There are relatively few standards, tons of companies, and lots of failures. It costs too much, it doesn’t work as well as you’d think, and there are way too many avoidable errors.
This is by Aaron Carroll, an advocate of EMRs.
Mar 22, 2011 | 12 comments | by John Goodman
Bad News for Electronic Medical Records
The percentage of doctors saying that the financial benefits of electronic records outweigh the costs fell to 64% from 71% last year. And the percentage saying the patient-care benefits justified the financial investment fell to 68% from 73%. This year’s survey also found doctors were less likely to agree that electronic records can help reduce medical errors, improve efficiency and lower costs. And a greater proportion of physicians said electronic records slow them down and don’t achieve a measurable financial impact.
Full article on doctors’ views of electronic medical records.
Mar 04, 2011 | 7 comments | by John Goodman
Bad News on E-Health: There’s No Payoff
Sheikh and his colleagues scrutinized 53 reviews of the evidence surrounding technologies including electronic medical records, computerized provider order entry and computerized decision-support systems. The strength of the evidence varied from technology to technology, but in general the review found that “many of the clinical claims made about the most commonly deployed [digital health] technologies cannot be substantiated by the empirical evidence,” the authors write.
Full article on the downside of computerized ordering systems.
Feb 09, 2011 | 7 comments | by John Goodman
More Evidence Against EMRs, and Other News
More evidence that EMRs are not improving the quality of care.
Medicare Chief Actuary: Claims that ObamaCare will reduce medical costs are “false, more than true.”
Another disappointing study result: Pay for Performance doesn’t work.
Jan 27, 2011 | 4 comments | by John Goodman
What It’s Like to Work in an ACO
This is Caroline Poplin, writing at the Health Affairs Blog:
I am a Board-certified general internist. I worked for many years for…an Accountable Care Organization. It was factory work: we were interchangeable cogs in a vast machine. The people who saw patients, especially “primary care providers” like me, were at the base of the pyramid and the bottom of the pecking order.
The future is clear. The management of the ACO — professional administrators, and physicians who see few if any patients — will schedule every moment of every primary provider’s day, critique every decision, continually scrutinize and evaluate every aspect of one’s practice. At my ACO, yes, we were on teams, but given no time to communicate with one another. We were forced to complete clunky electronic records we had no time to read. Despite years of training and experience, we had no input to the system that controlled our lives. We were not respected as professionals. It was demoralizing.
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Jan 19, 2011 | 7 comments | by John Goodman
“Nurse of the Year” to Spend 9 Months in Prison, and Other News
“Nurse of the Year” convicted for practicing without a license. Will spend nine months in prison.
“Rock Doc,” with hair spiked, punk style hair, wearing chains, bangles and leather bracelets, earns $1.2 million a year from Medicare. Says his physical therapy regimen “does wonders” if used correctly.
RAND: Electronic medical records have a limited effect on quality of care. “[Q]uality scores improved no faster at hospitals that had newly adopted a basic electronic health record than in hospitals that did not.”
Jan 05, 2011 | 5 comments | by John Goodman
Surprising Result: Medicaid Patients Most Likely to Use EMRs
When offered the opportunity to manage their own care, using a computerized personal health record (PHR), 26% did so. But of the group (1/3 Medicaid, 1/3 Medicare and 1/3 employer plans) the highest use by far was among Medicaid patients:
The PHR provides patients with access to their problem list, vitals (height, weight, blood pressure, BMI), medication lists, basic lab results, A1C results (can be charted for track and trend) and basic demographic information… They have purposely kept the PHR simple and focused on the treatment of diabetes.
The highest adoption and use of the PHR is among Medicaid patients, who make up a whopping 87% of all diabetic patients…using the PHR. Why the strong adoption among this sub-group? Fragmented care…Medicaid patients must move from one provider or clinic to another to receive treatment — there is no consistency for this group as to where they receive their care and the PHR provides this group a “medical home” for their PHI which they value.
Full article on personal health records for Medicaid patients.
Dec 01, 2010 | 4 comments | by John Goodman
